Clinical Results of Using the Proximal Humeral Internal Locking System Plate for Internal Fixation of Displaced Proximal Humeral Fractures

Proximal humerus fractures are accounting for 4-5% of all fractures with increasing incidence.

Proximal Humeral Internal Locking System (PHILOS) plate is a new plate which permits early mobility and lowers the risk of complications. The aim of this study was to evalu­ate the functional outcome and the complication rate after using this plate.

Between 2006-2008, 37 patients with displaced 2-, 3- and 4-part fractures of the proximal humerus were operated on using PHILOS plate. The mean range of follow-up was 12 months. Twenty patients were 60 years and younger, and 17 patients were older than 60 years. The average American Shoulder and Elbow Surgeons (ASES) score at the final follow-up was 77.62. According to Michener and colleagues classification, 5.4% of patients had an excel­lent outcome, 72.9% were minimally functionally limited, 16.2% were moderately functionally limited, and 5.4% were maximally functionally limited. The average ASES score between patients 60 years and older and those 60 years and younger was not significantly different. One patient developed avascular necrosis of the humeral head, 2 patients developed an infection, and no patients devel­oped a nonunion.

Fixation with PHILOS plate can be considered a good method with high union rates for this kind of fracture, espe­cially in the older population with osteoporotic bone.